The Federal Ministry of Health (FMOH) of Nigeria and partners have made
considerable efforts to combat maternal, newborn, and child health illnesses.
Despite this, the burden of these conditions in Nigeria remains high. Results
from the latest Demographic and Health Survey (Measure DHS 2008) of 2008 showed
that Nigeria is still a long way from meeting the Millennium Development Goal
(MDG) goals 4 and 5, which relate to reducing the burden in child and maternal
deaths by 2015, respectively. In this survey, the infant mortality rate (per
1,000 live births) was estimated at 75 and the percentage of births attended by
skilled health personnel was 38.9 percent. Immunization rates remain low,
especially among rural populations.

To accelerate progress toward meeting the MDG goals, the FMOH and partners
have developed a number of strategic interventions, especially at primary health
care level. These interventions aim at increasing basic antenatal, newborn, and
child care for the most vulnerable populations, with the goal of saving
approximately one million lives by 2015. The key to these interventions is to
provide medicines and health commodities. In July and August 2012, the office of
the honorable Federal Minister of State for Health, with technical assistance
from the USAID | DELIVER PROJECT, Task Order 4, conducted a forecast and funding
gap analysis of commodities for maternal, newborn, and child health (MNCH) in
Nigeria for one year.

Using morbidity information from various sources, the USAID | DELIVER PROJECT
carried out a morbidity-based forecast. This report includes the findings from
the forecast, as well as the funding gap analysis that can be used for advocacy
with key stakeholders to increase the level of funding and eventual availability
of commodities for MNCH conditions in Nigeria. The project quantified the main
commodities needed for a comprehensive MNCH program in Nigeria, by commodity
groups. These groups were nutrition, antimalarials, essential medicines, HIV and
AIDS medicines and supplies, vaccines, family planning commodities, and general
health consumables (e.g., syringes, giving sets, mama kits, etc.). In total, the
project estimated the funding requirements for 135 medicines and 67 general
health supplies. The quantification team used purchase prices that states and
program representatives reported. If local prices were not available, we used
the International Drug Price Indicator Guide (MSH and WHO 2011) median prices.

The USAID | DELIVER PROJECT estimated an annual funding requirement of
approximately U.S.$859,496,126. Using information from the state-level ministry
of health (MOH) officials, the FMOH, and partners, we estimated that
$361,719,211, of this is currently funded, leaving a funding gap of
approximately $497,776,915. In Nigeria, this is an annual expenditure of
approximately $5.00 per person. Using the Lives Saved tool in the Spectrum set
of models, we estimated that providing these medicines and commodities to a
level of coverage sufficient to reach the 2015 MDG targets would result in a
significant reduction in maternal, newborn, and child deaths by 2015. For
example, the team estimated the potential reduction for child deaths only if the
MDG targets were met by 2015 could be up to 750,000 lives. Ensuring that the
necessary commodities are available in public health facilities for the trained
service providers will definitely contribute to saving the lives of mothers,
newborns, and children, and to meeting the Government of Nigeria’s ambitious,
“Saving One Million Lives Initiative.”

Going forward, the USAID | DELIVER PROJECT recommends that the results of
this forecast and funding gap analysis should be used by the FMOH and partners
to source for funding. Concurrently, a supply plan that takes into account
existing stock levels, as well as commodities that may already be on order needs
to be developed in order to inform the procurement of these commodities.
Finally, a national forum for all stakeholders (including state-level
representatives) needs to be created to meet regularly and chart a way forward
toward creating MNCH commodity security for Nigeria.